1447353644 NPI number — AMERICAN DRUG CENTER, INC.

Table of content: (NPI 1447353644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447353644 NPI number — AMERICAN DRUG CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN DRUG CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447353644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2322 E LITTLE CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23518-3225
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-480-6402
Provider Business Mailing Address Fax Number:
757-480-8395

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1940 LASKIN RD
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23454-4278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-428-0787
Provider Business Practice Location Address Fax Number:
757-425-5706
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GULIANI
Authorized Official First Name:
RANJEEV
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
757-971-2426

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009119108 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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